Provider Demographics
NPI:1487846911
Name:KIMATA, LORI G (ND)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:G
Last Name:KIMATA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 VANCOUVER PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-2453
Mailing Address - Country:US
Mailing Address - Phone:808-783-0361
Mailing Address - Fax:808-946-3757
Practice Address - Street 1:1843 VANCOUVER PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2453
Practice Address - Country:US
Practice Address - Phone:808-783-0361
Practice Address - Fax:808-946-3757
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND-81175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath